Thursday, December 22, 2005

The arthroscopic shoulder surgery went well

I had my arthroscopic shoulder surgery on Monday at UCLA Medical Center. The original injury in March (doing a "dislocate" on Still Rings when I wasn't warmed up) never healed on its own nor did a few months of physical therapy make it any better. After an inconclusive MRI (only shoulder minor tendon irritation), the next step was arthroscopic surgery where they stick a camera inside and see for themselves what's going on.

The nice bonus with arthroscopic surgery is that not only can they see what's wrong, but they can usually fix it while they're in there. Somehow with three small incisions they can place the camera and their tools in there to get the job done. Pretty amazing. Recovery time is obviously quicker too since you aren't being completely opened up.

Before the surgery they had me write "Yes" on the arm that was to be operated on. It's surprisingly difficult to write with your left hand on your own arm. The nurse was very impressed with the legibility of my "Yes". Dawn was pretty amused to see it while I was in the recovery room afterwards and had to take a picture of it.

They gave me an optional nerve block on the entire right arm. Getting the nerve block in kind of sucked - they have to insert an electrode into the area between your neck and traps muscle and poke around until they find the right spot on the nerve trunk. They test the position by sending a small current through the electrode causing your arm, elbow, whatever to twitch. When they jacked up the current to get a good solid test, the resulting muscle spasm is a little painful. They must have had me slightly sedated because normally that whole deal would have freaked me out more than it did.

Then I was put under general anaesthesia before the 90-minute surgery began. The next thing I remembered was dry heaving as I came out of it. I didn't wake up and then start heaving - the heaving woke me up. They said that they administered some anti-nausea drug and that calmed me down some.

Overall it was a struggle to recover from the general anaesthesia. I was really tired but not exactly sleepy. The nausea was really annoying. The nurse came by fifteen minutes later and declared, "you look like you're coming out of the haze a bit more". She was right - I hadn't realized that I was in a haze until she made that remark. It made me realize that I was more aware of my surroundings, rather than just sitting in a haze of shivery, exhausted nausea. It was a little surprising how cold I was. It took a while to feel warm again, even after they piled on warm blankets.

I really wanted to sleep but I wasn't sleepy enough even though I felt exhausted. But the bigger problem was the nerve block on my right arm. I wasn't feeling any pain at all because I couldn't feel that arm at all. Couldn't twitch it, couldn't feel my hand touching the skin, nothing. It completely freaked me out. I just couldn't stop thinking about my dead, missing arm.

It's like when you wake up in the middle of the night and a limb has fallen asleep. Whenever that happens to me I instantly panic and thrash around until feeling returns. Only this time that wasn't an option. I tried to just lay still and ignore it, but I couldn't. My brain believed that my dead arm felt cold, but when I touched it with my left hand it actually felt really warm - as if they had packed a heat pack in there with it. Somehow psychologically it was better when I held the warm dead hand with my left. It gave my brain at least a little feedback about how that limb was doing.

The wooziness from the anaesthesia wore off fairly quickly but I was still a little queasy. The nurse let me swish water around in my mouth but wouldn't let me swallow it. She said it would just make me want to vomit again. I was hooked up to a full saline bag and she waited for it to all drain into me. She said the liquid would really help fight off the nausea.

My surgeon was in another surgery so I didn't get a chance to talk to him about how things went. After another half hour or so they let me get dressed and finally go to the bathroom to relieve my bladder. They pumped me so full of liquids during surgery and recovery. And I've found that I just can't pee into the little container while lying down. I couldn't do it after my foot surgery and I couldn't do it here. The combination of gravity fighting you and a lifetime's worth of training myself not to pee in my bed make it impossible for me.

They discharged me pretty soon after and I rode home in my sister's car. Three-quarters of the way back to my apartment I had to have her pull over because I was feeling sick. I dry heaved a few times and felt a lot better. She got me back to the apartment without incident.

For the first few hours I mostly just sat in a chair or my roommate's recliner. I still couldn't sleep because the dead arm still freaked me out. As the effects of the general anaesthesia diminished I felt completely awake and not really tired. Still no pain in my arm but the dead arm really continued to bother me. I started pacing around the room, trying to get my heart rate up, thinking that the more active I was, the quicker my body would get over the nerve block.

I did start to get some feeling in my palm and wrist. I could vaguely feel sensations and I could vaguely sense heat. The walking around seemed to help and within half an hour I could feel something in my pointer finger. After another hour or two I was starting to get sensation in all my fingers. Three or four hours later I could barely twitch them.

As the nerve block started to give way I figured I better take a painkiller before the pain really kicked in. I couldn't eat much - some water and two pieces of bread were a huge victory after an entire afternoon of nausea - so about an hour after I took the first hydrocodone I vomitted a few times again. But the stuff worked and I really didn't feel any pain.

That night I slept in my roommate's recliner - the elevation made it much more comfortable since my arm was in a sling. It was just too uncomfortable to lay on my back while my forearm kind of jutted straight upwards. The recliner let me nestle my elbow into a corner without pushing up into my shoulder.

I didn't sleep all that well, but slept enough.

More to come - including pictures from Day 4 when I got to take the bandages off!

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